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Article ; Online: Hematoma de músculo iliopsoas na vigência de tratamento com varfarina Hematoma de músculo iliopsoas en la vigencia de tratamiento con warfarina Iliopsoas muscle hematoma during treatment with warfarin

Gabriel Zago / Marcelo Campos Appel-da-Silva / Luiz Claudio Danzmann

Arquivos Brasileiros de Cardiologia, Vol 94, Iss 1, Pp e1-e

2010 Volume 3

Abstract: A varfarina é droga amplamente utilizada na prevenção de fenômenos tromboembólicos e o conhecimento de seus efeitos adversos faz-se necessário para o acompanhamento dos pacientes. Embora o desenvolvimento de discrasias sanguíneas seja complicação ... ...

Abstract	A varfarina é droga amplamente utilizada na prevenção de fenômenos tromboembólicos e o conhecimento de seus efeitos adversos faz-se necessário para o acompanhamento dos pacientes. Embora o desenvolvimento de discrasias sanguíneas seja complicação potencial nesses pacientes, a ocorrência de sangramento retroperitoneal é rara. Este artigo discute o caso de um paciente que evoluiu com hematoma do músculo iliopsoas durante tratamento com a referida droga, pós-implante de prótese aórtica metálica, com quadro clínico envolvendo importantes diagnósticos diferenciais. La warfarina es un fármaco ampliamente utilizado en la prevención de fenómenos tromboembólicos, y el conocimiento de sus efectos adversos se hace necesario para el seguimiento de los pacientes. Aunque el desarrollo de discrasias sanguíneas es la complicación potencial en estos pacientes, la ocurrencia de sangrado retroperitoneal es rara. Este artículo discute el caso de un paciente que evolucionó con hematoma del músculo ileopsoas durante tratamiento con el referido fármaco en el postimplante de prótesis mitral metálica, con cuadro clínico implicando importantes diagnósticos diferenciales. Warfarin is a widely used drug for the prevention of thromboembolic events. Knowledge of its adverse effects is necessary for patient follow-up. Although the development of blood dyscrasias is a potential complication in these patients, retroperitoneal bleeding is rare. This article reports the case of a patient who developed iliopsoas muscle hematoma during treatment with warfarin after implantation of a metallic prosthetic aortic valve. The clinical manifestations involved important differential diagnoses.
Keywords	Coagulación sanguínea ; warfarina ; hematoma ; espacio retroperitoneal ; músculos psoas ; Coagulação sanguínea ; varfarina ; espaço retroperitoneal ; blood coagulation ; warfarin ; retroperitoneal space ; psoas muscles ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Sociedade Brasileira de Cardiologia - SBC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Educação e Vulnerabilidade a DST/HIV entre Militares em um Quartel em Porto Alegre, RS

Marcelo Campos Appel da Silva / Vicente Sperb Antonello / Elisa Sfoggia Romagna / Jerônimo Sperb Antonello

Clinical and Biomedical Research, Vol 29, Iss

2010 Volume 3

Abstract: As doenças sexualmente transmissíveis (DST) são assunto freqüente nos diversos veículos de informação, acessíveis a todas as faixas etárias e classes sociais, e alvo de campanhas de divulgação, educação e prevenção, motivadas pela grande relevância deste ...

Abstract	As doenças sexualmente transmissíveis (DST) são assunto freqüente nos diversos veículos de informação, acessíveis a todas as faixas etárias e classes sociais, e alvo de campanhas de divulgação, educação e prevenção, motivadas pela grande relevância deste grupo de doenças em matéria de saúde pública. Apesar disso, ainda são crescentes os casos de DST em serviços de atendimento primário de saúde, o que põe em questionamento as razões para tal incapacidade de controle destas doenças. O presente trabalho teve por objetivo verificar o conhecimento dos soldados recrutas de um quartel em Porto Alegre, RS, acerca da transmissão do vírus HIV, bem como verificar a ocorrência de práticas comportamentais de risco para transmissão ou aquisição de DST. Após aprovação do projeto por comitê de ética em pesquisa, autorização pelo comandante da organização militar selecionada e consentimento dos sujeitos da pesquisa, foi aplicado um questionário semi-estruturado aos soldados incorporados no ano de 2007 em um quartel em Porto Alegre, RS. Os resultados deste trabalho mostram que embora exista adequado conhecimento sobre as formas de transmissão do vírus HIV pela maioria dos entrevistados, há ocorrência de comportamentos de risco, como a pratica de sexo sem preservativos nas relações sexuais, e há referência à percepção de que a ocorrência de DST é pouco possível em suas vidas. Infere-se, com base nestes resultados, que embora haja conhecimento correto sobre as formas de transmissão de DST pela população estudada, há, também, falta de comprometimento e responsabilidade ao não praticar sexo de forma segura.
Keywords	Comportamento Sexual ; Doenças Sexualmente Transmissíveis ; HIV ; Síndrome de Imunodeficiência Adquirida ; Militares ; Medicine ; R
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Hospital de Clinicas de Porto Alegre
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Immune restoration in human immunodeficiency virus and hepatitis C virus coinfected patients after highly active antiretroviral therapy

Vicente Sperb Antonello / Marcelo Campos Appel-da-Silva / Dimas Alexandre Kliemann / Breno Riegel Santos / Cristiane Valle Tovo

Brazilian Journal of Infectious Diseases, Vol 17, Iss 5, Pp 551-

2013 Volume 554

Abstract: OBJECTIVE: To evaluate the influence of hepatitis C virus on immunological and virological responses after highly active antiretroviral therapy initiation in human immunodeficiency virus/hepatitis C virus coinfected patients compared to monoinfected ... ...

Abstract	OBJECTIVE: To evaluate the influence of hepatitis C virus on immunological and virological responses after highly active antiretroviral therapy initiation in human immunodeficiency virus/hepatitis C virus coinfected patients compared to monoinfected human immunodeficiency virus-infected patients. METHODS: The study enrolled 65 human immunodeficiency virus-1-infected subjects who initiated highly active antiretroviral therapy and attended follow-up visits over 48 weeks from 2008 to 2010. They were grouped based on hepatitis C virus-RNA results. Virological and immunological responses were monitored at baseline and at the end of weeks 12, 24, 36, and 48. RESULTS: There were 35 human immunodeficiency virus monoinfected and 30 human immunodeficiency virus/hepatitis C virus coinfected patients. In the present study human immunodeficiency virus/hepatitis C virus coinfection did not seem to influence CD4 Tlymphocytes recovery. There was no difference between the curves of CD4 T-lymphocytes raise of coinfected and monoinfected groups. CONCLUSION: This prospective study confirms that hepatitis C virus infection does not seem to be associated with impaired CD4 T-lymphocytes recovery after HAART.
Keywords	HIV ; Hepatitis C ; Coinfection ; HAART ; CD4 ; Immunological response ; Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	English
Publishing date	2013-10-01T00:00:00Z
Publisher	Brazilian Society of Infectious Diseases
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Percutaneous liver biopsy - 2 decades of experience in a public hospital in the South of Brazil

Rafael Bergesch D’Incao / Marcelo Campos Appel da Silva / Paulo Roberto Lerias de Almeida / Viviane Plasse Renon / Cristiane Valle Tovo

Annals of Hepatology, Vol 12, Iss 6, Pp 876-

2013 Volume 880

Abstract: Introduction. Liver biopsy is a complementary method for diagnosis, staging and therapeutic guidance in liver diseases, where chronic viral hepatitis are the most acknowledged causes for the indication of histopa-thological study. The objective is to ... ...

Abstract	Introduction. Liver biopsy is a complementary method for diagnosis, staging and therapeutic guidance in liver diseases, where chronic viral hepatitis are the most acknowledged causes for the indication of histopa-thological study. The objective is to assess the patients’ profile as well as the indication and results of percutaneous liver biopsies in a tertiary hospital.Material and methods. A descriptive, cross-section study was carried out through the review of medical charts (retrospective cohort) of patients submitted to blind percutaneous liver biopsies (PLB) at a hospital in Porto Alegre, South Brazil, from October 1993 to December 2011.Results. 1,955 PLB were carried out, the mean patients’ age was 44.8 years old, and 1,127 (57.65%) were men. Chronic hepatitis C was the main indication (60.5%), followed by HCV-HIV coinfection (12.2%) and chronic hepatitis B (3.5%). Seven cases (0.3%) had complications, without deaths.Conclusion. PLB is a safe method and continues to be an important option to assist patients with chronic liver disease.
Keywords	Liver biopsy ; Chronic hepatitis ; Hepatitis C ; Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2013-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Whipple's disease

Viviane Plasse Renon / Marcelo Campos Appel-da-Silva / Rafael Bergesch D'Incao / Rodrigo Mayer Lul / Luciana Schmidt Kirschnick / Bruno Galperim

Revista do Instituto de Medicina Tropical de São Paulo, Vol 54, Iss 5, Pp 293-

rare disorder and late diagnosis

2012 Volume 297

Abstract: Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints ... ...

Abstract	Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints intermittent diarrhea, and a 10-kg weight loss in one year. Laboratory tests showed the following results: Hb = 7.5 g/dL, albumin = 2.5 mg/dL, weight = 50.3 kg (BMI 17.4 kg/m²). Upper gastrointestinal endoscopy revealed areas of focal enanthema in the duodenum. An endoscopic biopsy was suggestive of Whipple's disease. Diagnosis was confirmed based on a positive serum polymerase chain reaction. Treatment was initiated with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole. After one year of treatment, the patient was asymptomatic, with Hb = 13.5 g/dL, serum albumin = 5.3 mg/dL, and weight = 70 kg (BMI 24.2 kg/m²). Whipple's disease should be considered a differential diagnosis in patients with prolonged constitutional and/or gastrointestinal symptoms. Appropriate antibiotic treatment improves the quality of life of patients.
Keywords	Whipple's disease ; Tropheryma whipplei ; Malabsorption syndromes ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	2012-10-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Caso para diagnóstico Case for diagnosis

Jayme Eduardo Burmeister / Diego da Rosa Miltersteiner / Marcelo Campos Appel da Silva / Claudio Galeano Zettler / Luciana Weis

Anais Brasileiros de Dermatologia, Vol 86, Iss 2, Pp 391-

2011 Volume 391

Abstract: Dermatose perfurante adquirida é uma condição rara, em geral associada a algumas doenças sistêmicas, ocorrendo especialmente em pacientes diabéticos com insuficiência renal crônica submetidos a diálise. O sintoma principal é o prurido e a apresentação ... ...

Abstract	Dermatose perfurante adquirida é uma condição rara, em geral associada a algumas doenças sistêmicas, ocorrendo especialmente em pacientes diabéticos com insuficiência renal crônica submetidos a diálise. O sintoma principal é o prurido e a apresentação clínica característica é a presença de lesões papulares marrom-avermelhadas no tronco, cabeça e pescoço. Biópsia da lesão revela invaginação epidérmica com preenchimento por plug ceratótico. A etiologia é pouco compreendida e várias tentativas terapêuticas têm sido desapontadoras. Acquired perforating dermatosis is a rare condition often associated with some systemic diseases, especially diabetic patients with chronic renal failure undergoing dialysis. The main symptom is pruritus and it is clinically characterized by the presence of redish-brown papular lesions in the trunk, head and neck. Biopsy of the lesion reveals epidermal invagination with keratotic plug. The etiology is poorly understood and several therapeutic measures have been disappointing.
Keywords	Dermatopatias ; Diabetes mellitus ; Falência renal crônica ; Insuficiência renal crônica ; Kidney failure ; chronic ; Renal insufficiency ; Skin diseases ; Dermatology ; RL1-803 ; Medicine ; R ; DOAJ:Dermatology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2011-04-01T00:00:00Z
Publisher	Sociedade Brasileira de Dermatologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Síndrome de Wellens Síndrome de Wellens Wellens syndrome

Marcelo Campos Appel-da-Silva / Gabriel Zago / Aníbal Pereira Abelin / Walter Otávio Pin / Oscar Pereira Dutra / Renato Vaz

Arquivos Brasileiros de Cardiologia, Vol 94, Iss 4, Pp e116-e

2010 Volume 119

Abstract: A avaliação de dor torácica é prática de rotina em serviços de emergência. Embora seja queixa comum e com amplo diagnóstico diferencial. é na suspeita de síndrome coronariana aguda (SCA) que a preocupação é maior. Eletrocardiograma e dosagem de enzimas ... ...

Abstract	A avaliação de dor torácica é prática de rotina em serviços de emergência. Embora seja queixa comum e com amplo diagnóstico diferencial. é na suspeita de síndrome coronariana aguda (SCA) que a preocupação é maior. Eletrocardiograma e dosagem de enzimas cardíacas são ferramentas importantes na investigação dos pacientes. mas. quando negativos. podem não identificar algumas doenças. Relatamos o caso de uma paciente com angina. cujos exames iniciais na emergência não apresentavam alterações sugestivas de cardiopatia isquêmica. Doença de conhecimento recente. a síndrome de Wellens consiste em uma variante da angina instável. que. quando não reconhecida. pode acarretar em significativa morbidade e mortalidade. La evaluación de dolor torácico es práctica de rutina en servicios de emergencia. Aunque es queja común y con amplio diagnóstico diferencial, es en la sospecha de síndrome coronario agudo (SCA) que la preocupación es más grande. Electrocardiograma y dosificación de enzimas cardíacas son herramientas importantes en la investigación de los pacientes, sin embargo, cuando negativos, pueden no identificar algunas enfermedades. Referimos el caso clínico de una paciente con angina, cuyos exámenes iniciales en la emergencia no presentaban alteraciones sugestivas de cardiopatía isquémica. Enfermedad de conocimiento reciente, el síndrome de Wellens consiste en una variante de angina inestable, que cuando no reconocida, puede conllevar significativa morbilidad y mortalidad. The assessment of chest pain is a routine in emergency health services. Although this is a common complaint with a broad differential diagnosis. the major concern is the possibility of acute coronary syndrome (ACS). Electrocardiography and cardiac enzyme levels are important tools in the investigation of these patients; however. negative results may actually be overlooking the identification of some conditions. We report the case of a female patient with angina. whose baseline tests in the emergency room were negative for changes suggestive of ischemic heart disease. The Wellens syndrome. a recently described disease. is a variant of unstable angina which. if not identified. may result in significant morbidity and mortality.
Keywords	Cardiopatía isquémica ; síndrome coronario agudo ; angina inestable ; electrocardiografía ; Cardiopatia isquêmica ; síndrome coronariana aguda ; angina instável ; eletrocardiografia ; Myocardial ischemia ; acute coronary syndrome ; angina ; unstable ; electrocardiography ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2010-04-01T00:00:00Z
Publisher	Sociedade Brasileira de Cardiologia - SBC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Treatment of severe chromoblastomycosis with itraconazole and 5-flucytosine association

Vicente Sperb Antonello / Marcelo Campos Appel da Silva / Eduardo Cambruzzi / Dimas Alexandre Kliemann / Breno Riegel Santos / Flávio Queiroz-Telles

Revista do Instituto de Medicina Tropical de São Paulo, Vol 52, Iss 6, Pp 329-

2010 Volume 331

Abstract: Chromoblastomycosis is a chronic human melanized fungi infection of the subcutaneous tissue caused by traumatic inoculation of a specific group of dematiaceous fungi through the skin, often found in barefooted agricultural workers, in tropical and ... ...

Abstract	Chromoblastomycosis is a chronic human melanized fungi infection of the subcutaneous tissue caused by traumatic inoculation of a specific group of dematiaceous fungi through the skin, often found in barefooted agricultural workers, in tropical and subtropical climate countries. We report the case of a male patient presenting a slow-growing pruriginous lesion on the limbs for 20 years, mistreated over that time, which was diagnosed and successfully treated as chromoblastomycosis. Besides the prevalence of this disease, treatment is still a clinical challenge.
Keywords	Chromoblastomycosis ; Itraconazole ; 5-Flucytosine ; Subcutaneous mycoses ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	2010-12-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ageusia e anosmia na vigência de tratamento com leflunomida para artrite reumatóide (AR)

Marcelo Campos Appel da Silva / Vicente Sperb Antonello / Fernando Appel da Silva

Revista Brasileira de Reumatologia, Vol 45, Iss 6, Pp XVI-XVII (2005)

2005

Keywords	Diseases of the musculoskeletal system ; RC925-935 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	2005-12-01T00:00:00Z
Publisher	Sociedade Brasileira de Reumatologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Muscle depletion in cirrhotic patients assessed using computed tomography

Elisa Sfoggia Romagna / Marcelo Campos Appel-da-Silva / Eiji Suwa / Fabio Kunihiro Maeda / Angelo Alves de Mattos / Cristiane Valle Tovo

São Paulo Medical Journal, Vol 138, Iss 2, Pp 152-157

a cross-sectional study

Abstract: ABSTRACT BACKGROUND: Sarcopenia is a common complication in patients with cirrhosis and may lead to increased morbidity and mortality. OBJECTIVE: To investigate the prevalence of sarcopenia and its association with disease severity scores, among patients ...

Abstract	ABSTRACT BACKGROUND: Sarcopenia is a common complication in patients with cirrhosis and may lead to increased morbidity and mortality. OBJECTIVE: To investigate the prevalence of sarcopenia and its association with disease severity scores, among patients with cirrhosis. DESIGN AND SETTING: Observational and retrospective cohort study carried out in a tertiary-care hospital in southern Brazil. METHODS: This study was conducted among patients with chronic liver disease who were followed up at the gastroenterology and hepatology outpatient clinic of a tertiary-care hospital in southern Brazil and who underwent computed tomography scans of the abdomen through any indication. RESULTS: We included 83 patients in the study. In the population evaluated, there was a predominance of males (57.80%) and the mean age was 56 years. Hepatitis B or C virus was present in the genesis of the disease in 34.9% of the cases, followed by an etiology of alcohol abuse (30.1%). Sarcopenia was diagnosed in 41 (49.4%) of the patients when the cutoff point for cirrhotic patients was used. There was no significant correlation between the Child-Pugh and MELD severity scores and the occurrence of sarcopenia. CONCLUSION: Sarcopenia presents high prevalence among patients with chronic liver disease, without any association with predictors of severity.
Keywords	liver cirrhosis ; sarcopenia ; mortality ; malnutrition ; muscle depletion ; cirrhosis ; chronic liver disease ; Medicine ; R
Subject code	610
Language	English
Publisher	Associação Paulista de Medicina
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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